fainting during surgery?

[Nebmuse]

I agree that the temp in the OR is one of the biggest factors. I loved my surgery rotation. I've been into surgery many times before my rotation began, so I knew that I had was one of those who sometimes had issues with getting light headed. I made it through the first month just fine. I was at the University and those OR's were COLD. I spent the second month at Children's and was having issues with light-headedness frequently. Those OR's are HOT. It wasn't the procedures. I did find that having something cool and wet in my hand worked fairly well to keep things under control. Even though I had to scrub out several times at Children's, I got a superior evaluation because I worked really hard, was always prepared, and the attendings and residents knew it. My advice - if you have to scrub out and leave the room, don't stay out too long, go back in when you are better.

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[sandg]

Has anyone had trouble with psyhcing him/herself out after a legitimate vasovagal-mediated fainting episode? Let me explain. As an M1, I was shadowing in the ED and passed out watching a femoral central line be placed. I've always had a thing for needles (a bad thing, that is) and was in a bad state (no food or drink in ~8 hrs, very hot). Seems like I should be able to avoid passing out again by correcting the hydration, food, etc. problems, as has been discussed above. Nonetheless, the thought of having passed out once makes me very nervous I'll do it again. Basically, it seems that passing out once has shaken my confidence in my toughness, which makes the tension go up, which stacks the deck in favor of fainting. Anyone experienced this and gotten over it?

 

[Iwy Em Hotep]

Has anyone had trouble with psyhcing him/herself out after a legitimate vasovagal-mediated fainting episode? Let me explain. As an M1, I was shadowing in the ED and passed out watching a femoral central line be placed. I've always had a thing for needles (a bad thing, that is) and was in a bad state (no food or drink in ~8 hrs, very hot). Seems like I should be able to avoid passing out again by correcting the hydration, food, etc. problems, as has been discussed above. Nonetheless, the thought of having passed out once makes me very nervous I'll do it again. Basically, it seems that passing out once has shaken my confidence in my toughness, which makes the tension go up, which stacks the deck in favor of fainting. Anyone experienced this and gotten over it?

Yes. My one time fainting during surgery was very early on, on a call night, after I hadn't eaten/drank/slept in almost 20 hours. It was my own fault, really, but I didn't know any better at the time. The fainting was bad enough, but getting an hour or so of sleep and knowing that I was going in on a 4 hour case in the morning was nerve-wracking.

In the end, I didn't faint on my morning case, although I came really close a couple of times and had to keep fidgeting to keep the blood going to my head. I tried hard not to think about fainting, even when I could see the darkness start to creep into my vision and roaring start to come on in my ears. Went home after that, drank about a carton of juice, slept for 12 hours, and was good to go the next day.

 

[BklynWill]

Nearly fainted today during my first scrub-in as an MSIII. We had a brutal c-section. Lots of blood and internal organs were made external. I was totally fine with all of that. I didn't even have a problem reaching into the uterus and pulling off the placenta. We were nearly done when the patient started to complain about pain. That just about did it for me. My stomach started burning and I felt the blood drain from my face. I was luckily able to excuse myself while a friendly nurse helped me scrub out, so I didn't completely pass out. I wanted to go back in a few minutes later but I decided against that considering I was probably a liability.

It's strange- I had a huge lunch, plenty of sleep, no history of hypo-anything. I guess it was all psychological. Maybe writing about it will help me get past a subconscious issue??

 

[DOctorJay]

I had 2 near syncopal episodes but was able to excuse myself from the situation, sit down, eat and rehydrate. Both were from not eating a proper breakfast in the morning (can't stand waking up that early and favor sleep over breakfast sometimes).

LESSON LEARNED, EAT BEFORE SURGERY

 

[ams8855]

I'm worried about this issue too. Once I fainted during a routine surgical consult, another during a surgical biopsy, three times while giving a blood sample, and just last week while doing neonatal lab while watching the doc examine the baby. It's so frustrating! I seriously stuff myself with food beforehand to try to avoid hypoglycemia and hydrate myself as much as possible but it just doesn't seem to work. I did shadow a family practitioner before coming to med school and had no problems there because she always had me doing something like getting supplies or filling out prescriptions. Next year on rotations should be interesting to say the least. Are most rotations observation-only? Maybe I could explain my situation and they'd let me do something to prevent from passing out or is that kind of overstepping my limits as a 3rd year med student? Oh well, me and the floor will be best friends I suppose.

 

[kate_g]

Once I fainted during a routine surgical consult, another during a surgical biopsy, three times while giving a blood sample, and just last week while doing neonatal lab while watching the doc examine the baby. It's so frustrating! I seriously stuff myself with food beforehand to try to avoid hypoglycemia and hydrate myself as much as possible but it just doesn't seem to work.

At the risk of sounding like I'm giving medical advice, which I am in no way qualified to do, this sounds a lot like me before I was diagnosed as anemic - particularly the strong correlation with (your own) blood loss. Might wanna go see your doctor, you might be able to cure or at least improve the symptoms.

 

[kmellowyellow]

I know this thread is old, but it's been two years since we've had funny fainting stories and there must be some new ones!

I'll start...I was in a peds uro case (note: peds=hot OR) and as soon as they made the first incision I started to feel the nausea and lightheadedness. It's a familiar sensation to me, so I think I might be a tad anemic, but I always overestimate myself pre-op and regret it intra-op. The attending had good music on and over the next fifteen minutes I got my groove on more and more emphatically, trying to stave off the humiliation of toppling over. Eventually he asked if I was ok and I told him I had to sit down. He was cool about it, but every hour or so he would ask me scrub out and "get ready to take pictures" of the case.

 

[mglavin]

<p>i've had a history of these vasovagal episodes usually occuring immediately following a needle stick in my arm. I have found that thinking about something that makes me very angry seems to counter those darn parasympathectic outflows. I've had some success with this techique the last two episodes so it might be worth trying if your out of ideas.</p>

 

[Gallix23]

Hey guys,

I know I dug this thread up from the grave, but I found it on the search feature and figured I'd just use it instead of starting a new thread.

I'm a premedical student, but my main, #1 concern is that when I start medical school I won't be able to handle the sights and things (even though in the back of my mind, I know I will). However, I've never passed out, and I've never gotten sick besides having stomach bugs.

This is what bothers me; sometimes I get so anxious and panicky over the thought of throwing up/passing out, that I actually begin to feel faint/nauseous. It's really annoying, and it's something that I really want to kick before it gets worse. Do any of you guys have anything like this or know how I could possibly treat it?

 

[DaveinDallas]

Hey guys,

I know I dug this thread up from the grave, but I found it on the search feature and figured I'd just use it instead of starting a new thread.

I'm a premedical student, but my main, #1 concern is that when I start medical school I won't be able to handle the sights and things (even though in the back of my mind, I know I will). However, I've never passed out, and I've never gotten sick besides having stomach bugs.

This is what bothers me; sometimes I get so anxious and panicky over the thought of throwing up/passing out, that I actually begin to feel faint/nauseous. It's really annoying, and it's something that I really want to kick before it gets worse. Do any of you guys have anything like this or know how I could possibly treat it?

I wouldn't worry about it. By the time you get through your anatomy course and have taken off the top of the skull with a bone saw and bisected the cranial vault down to the sternal notch with a tree saw with four of your tank mates securing the specimen by holding the shoulders and stabilizing the neck, you probably will be over your tendency to faint. And that's first year, so you'll know early on if you can do this w/o passing out.....

And if you do pass out, your buds will probably laugh at your expense, help you get to the nurses office, record it on film and put it on youtube and you'll all laugh about it 20 years later at a reunion.....

Let's not sweat the little stuff, unless you like barf into a patient during a ileal-rectal anastamoses. Let's worry about getting into medical school first, and then through the first two years and then Step 1 before we start sweating about passing out during surgery. Lots of stuff to induce hypertension, hives and vomiting way, way before that, K?

Seriously, just relax. If you need to, go get on a beta blocker to reduce the anxiety and learn to focus your mind on your happy place...mines on a beach in southpac where I still have my 19 year old, 6 pack physique and lots of lovely blonde ladies who are single and find me fascinatingly interesting...

 

[Gallix23]

I wouldn't worry about it. By the time you get through your anatomy course and have taken off the top of the skull with a bone saw and bisected the cranial vault down to the sternal notch with a tree saw with four of your tank mates securing the specimen by holding the shoulders and stabilizing the neck, you probably will be over your tendency to faint. And that's first year, so you'll know early on if you can do this w/o passing out.....

And if you do pass out, your buds will probably laugh at your expense, help you get to the nurses office, record it on film and put it on youtube and you'll all laugh about it 20 years later at a reunion.....

Let's not sweat the little stuff, unless you like barf into a patient during a ileal-rectal anastamoses. Let's worry about getting into medical school first, and then through the first two years and then Step 1 before we start sweating about passing out during surgery. Lots of stuff to induce hypertension, hives and vomiting way, way before that, K?

Seriously, just relax. If you need to, go get on a beta blocker to reduce the anxiety and learn to focus your mind on your happy place...mines on a beach in southpac where I still have my 19 year old, 6 pack physique and lots of lovely blonde ladies who are single and find me fascinatingly interesting...

Thanks for this. I know I'm jumping the gun, but I'm the type of person who will worry about things like this before they even happen. I'm also the type of person who will begin to feel faint/nauseous while thinking about doing something, but fine while I'm actually doing it.

I wouldn't really want to go on meds for it, because I don't really want to think of it as a problem, more as just an obstacle sort of thing. I guess I just have to start living "in the now" and stop worrying about the future, hahah. Thanks again

 

[DaveinDallas]

Thanks for this. I know I'm jumping the gun, but I'm the type of person who will worry about things like this before they even happen. I'm also the type of person who will begin to feel faint/nauseous while thinking about doing something, but fine while I'm actually doing it.

I wouldn't really want to go on meds for it, because I don't really want to think of it as a problem, more as just an obstacle sort of thing. I guess I just have to start living "in the now" and stop worrying about the future, hahah. Thanks again

Negative perspiration.....believe me, I speak from experience when I tell you not to borrow trouble. My classmates probably think I'm the biggest worrier in captivity prior to ANY exam and usually do well.

Sufficient unto the day is the BS thereof.....

 

[The Angriest Bird]

Assuming you have gone thru the anatomy course with a cadaver, you shouldn't pass out in the OR just because it's gross.

Hypoglycemic, dehydration, sleep deprivation, overheat, can be real problems. Always keep yourself well hydrated. My personal experience tells me when I'm dehydrated I become exponentially more tired. Ice machines are omnipresent in the hospital. They are your best friends. Drink a small cup of water and ice every 2 hours. You will feel the difference.

 

[indo]

a handful of salted peanuts before heading to the OR will keep you from getting hypoglycemic.

 

[JenHeart]

One of my classmates passed out in the OR the first day of our surgery rotation. My attending said it happens to at least student every month and they get over it. My classmate ended up going to all the cases she was scheduled for and did fine on the rotation. Do whatever you can to prepare for it and I am sure you will be just fine

 

[surftheiop]

There's alot of stories in here involving people who havent eaten in "Y" hours.

Is finding time to eat during rotations (even if its just a banana or some other snack) a big problem? If so its kind of worrying to me because I always start to feel really crappy if I don't eat something like every 4 or 5 hours.

 

[45408]

There's alot of stories in here involving people who havent eaten in "Y" hours.

Is finding time to eat during rotations (even if its just a banana or some other snack) a big problem? If so its kind of worrying to me because I always start to feel really crappy if I don't eat something like every 4 or 5 hours.

Yeah, it definitely can be. You'll have down time, but unfortunately, you rarely know how long the down time is, so if you run off to the cafeteria, you might end up missing something big. If you carry something in your pockets, you'll certainly have time to eat that though. When I did a rotation in the ER, I once went an entire shift without eating, drinking or going to the bathroom. I hardly even realized it either, because I was just going going going.

Ironically, on my busiest rotation, I was most likely to eat 3 square meals a day. I did a month of trauma surgery, and we always had breakfast after pre-rounding and before rounds with the attending. There might have been one single day we didn't do that. We often got together for lunch too, since we didn't usually have a whole lot of scheduled cases (most trauma stuff rolls in after 4-5pm).

 

[SLUser11]

Yeah, it definitely can be. You'll have down time, but unfortunately, you rarely know how long the down time is, so if you run off to the cafeteria, you might end up missing something big. If you carry something in your pockets, you'll certainly have time to eat that though. When I did a rotation in the ER, I once went an entire shift without eating, drinking or going to the bathroom. I hardly even realized it either, because I was just going going going.

Ironically, on my busiest rotation, I was most likely to eat 3 square meals a day. I did a month of trauma surgery, and we always had breakfast after pre-rounding and before rounds with the attending. There might have been one single day we didn't do that. We often got together for lunch too, since we didn't usually have a whole lot of scheduled cases (most trauma stuff rolls in after 4-5pm).

A lot of that stuff can be resident-specific. For me, eating an actual meal with significant calories and protein is a priority....for that reason, I make sure that almost every day, myself and my students have time for lunch....even if it's only 5 minutes. If you've seen a surgery resident eat, you know that 5-10 minutes can accomodate a pretty big meal.

It's all about priorities....even when I'm slammed, during the day or on call, I usually don't miss too many meals. Other residents find meals less important, and they use their down time for other activities, and their students are forced to suffer through their food-less activities.

That being said, if you're stuck with one of those evil residents who routinely don't feel the need to eat lunch, granola bars in the white coat have always been a good idea....

 

[45408]

A lot of that stuff can be resident-specific. For me, eating an actual meal with significant calories and protein is a priority....for that reason, I make sure that almost every day, myself and my students have time for lunch....even if it's only 5 minutes. If you've seen a surgery resident eat, you know that 5-10 minutes can accomodate a pretty big meal.

It's all about priorities....even when I'm slammed, during the day or on call, I usually don't miss too many meals. Other residents find meals less important, and they use their down time for other activities, and their students are forced to suffer through their food-less activities.

That being said, if you're stuck with one of those evil residents who routinely don't feel the need to eat lunch, granola bars in the white coat have always been a good idea....

Here's hoping I get a resident interested in bodybuilding then for my sub-I.

 

[cajunchrisbu]

aww poor gallix

Maybe you should wait a few years before going to big kid school. We wouldn't want you to hurt yourself at the sight of a medical procedure of all things.

 

[45408]

aww poor gallix

Maybe you should wait a few years before going to big kid school. We wouldn't want you to hurt yourself at the sight of a medical procedure of all things.

oh, how cute. a pre-med being condescending to another pre-med.

 

[Darklord]

Luckily I saw my first surgery when I was 15-16, and now I know that surgery doesn't bother me. The incident actually sparked an interest in surgery.

 

[JeffLebowski]

Luckily I saw my first surgery when I was 15-16, and now I know that surgery doesn't bother me. The incident actually sparked an interest in surgery.

You're not immune.

Your role WATCHING a surgery is much different than scrubbing in to a surgery. When you're scrubbed in, you can't touch anything, you can't rub your eyes, you can't touch your face, you can't crouch, you can't put your head between your legs, you can't leave the room (much less get a drink of water or a bite to eat), and you have a piece of fabric over your mouth as you breathe. I'm not saying you'll have problems, I'm just saying it can happen to anyone and if it does, forgive yourself, laugh it off, and know how to avoid it.

 

[medstar21]

You're not immune.

Your role WATCHING a surgery is much different than scrubbing in to a surgery. When you're scrubbed in, you can't touch anything, you can't rub your eyes, you can't touch your face, you can't crouch, you can't put your head between your legs, you can't leave the room (much less get a drink of water or a bite to eat), and you have a piece of fabric over your mouth as you breathe. I'm not saying you'll have problems, I'm just saying it can happen to anyone and if it does, forgive yourself, laugh it off, and know how to avoid it.

This is definitely true... I watched many surgeries my sophomore year of college, even open heart where I was right above the patient's head. Its completely different being scrubbed in. The first time I scrubbed in on a c-section, didnt go well... thanks to all of the above mentioned issues, or at least most of them. Its so different...

 

[tfom08]

The only times I almost lost consciousness in the OR were when I was holding a retractor for a long time or watching a procedure for awhile and nobody was talking to me at all. I just got so bored that I actually started to fall asleep several times. Between the fatigue and length of some procedures and how warm it gets under the surgical gown, I had no problems falling asleep standing in the OR. It was always much easier when I had some stimulation whether it was being pimped or some other discussion.

 

[RedheadDoc]

Can someone offer me some advice? I'm starting med school soon and I'm wondering about rotations and especially surgery rotations because I have MS. Heat exacerbates it. With an OR being as hot as it can be, how can I do surgery rotation with MS? I don't plan to go into surgery obviously but I still have to complete 8 weeks of it in 3rd year.

 

[JeffLebowski]

Can someone offer me some advice? I'm starting med school soon and I'm wondering about rotations and especially surgery rotations because I have MS. Heat exacerbates it. With an OR being as hot as it can be, how can I do surgery rotation with MS? I don't plan to go into surgery obviously but I still have to complete 8 weeks of it in 3rd year.

What kind of heat specifically exacerbates it, and how bad is it when you get an exacerbation?

 

[RedheadDoc]

Warm temps in general. Like over the summer, I have to have air conditioning or it exacerbates it. Saunas exacerbate it, that kind of thing. The fatigue is the most noticeable problem when I'm in a hot environment. The fatigue can be extremely bad. Sometimes I have weakness and just a feeling of being sick in general.

 

[Winged Scapula]

Can someone offer me some advice? I'm starting med school soon and I'm wondering about rotations and especially surgery rotations because I have MS. Heat exacerbates it. With an OR being as hot as it can be, how can I do surgery rotation with MS? I don't plan to go into surgery obviously but I still have to complete 8 weeks of it in 3rd year.

The typical OR is kept between 68 and 72 degrees.

Pediatrics and Burns rooms are usually much warmer (ie, 80 degrees and above). CT Surgery rooms are often the coldest.

Of course, being under the lights, being anxious and wearing gowns can increase the temperature, but how hot do you have to be to exacerbate your MS? I once worked with PA who wore this cooling machine from Sharper Image around his neck...looked dorky, but it kept him cool. Don't wear a t shirt under your scrubs, wear the bouffant hat, etc. to keep yourself cooler.

 

[sprinkibrio]

Sigh. MS3 starts in two weeks and I'm not looking forward to it. During our MS2 hospital visits once a month I had to sit to prevent fainting just about every time. I never sit when it is me doing an H&P, but when I have to watch anything my mind is free to wander, and wander it does. I've had this problem since I was little... The first time I fainted was in 5th grade when the class took turns reading about insulin shots. I was going to go to see the med school psychiatrist but with Step I studying I haven't had the chance. I probably won't have a chance before MS3. It's gotten to the point where I think just worrying about fainting puts me over the edge... Too bad there aren't any drugs for panic disorder. I was going to ask the psych for a benzo... Anyone have any helpful advice? I probably will get over this on my own (like I did with phlebotomy), but be extremely embarassed in the process.

BTW, I have tried everything. I've eaten, drank gatorade, given myself phenylephrine for the adrenergic effects, pumped arms and legs to get blood flowing back to my heart, tried to control my thoughts which I am really bad at, etc. I never had a problem with anatomy or during autopsies, because those people are dead and have no pain. I'm a vegetarian so I like the anemic idea... *running to take some iron pills although I know that's not it*.

 

[aphistis]

Sigh. MS3 starts in two weeks and I'm not looking forward to it. During our MS2 hospital visits once a month I had to sit to prevent fainting just about every time. I never sit when it is me doing an H&P, but when I have to watch anything my mind is free to wander, and wander it does. I've had this problem since I was little... The first time I fainted was in 5th grade when the class took turns reading about insulin shots. I was going to go to see the med school psychiatrist but with Step I studying I haven't had the chance. I probably won't have a chance before MS3. It's gotten to the point where I think just worrying about fainting puts me over the edge... Too bad there aren't any drugs for panic disorder. I was going to ask the psych for a benzo... Anyone have any helpful advice? I probably will get over this on my own (like I did with phlebotomy), but be extremely embarassed in the process.

BTW, I have tried everything. I've eaten, drank gatorade, given myself phenylephrine for the adrenergic effects, pumped arms and legs to get blood flowing back to my heart, tried to control my thoughts which I am really bad at, etc. I never had a problem with anatomy or during autopsies, because those people are dead and have no pain. I'm a vegetarian so I like the anemic idea... *running to take some iron pills although I know that's not it*.

I may be biased from working in anesthesia (i.e. I'm the only person in the OR not wearing 25 layers), but in my opinion most surgeons want the operating room kept at a temperature of 68-72 degrees Kelvin. Heat sensitivity ought not be a problem unless, like Winged Scapula said, you're in a burn OR.

 

[sprinkibrio]

I've been on internal medicine for two weeks now and fainting has not been a problem at all. Things are completely different than I had expected since my brain is so occupied.

 

[rgerwin]

I LOVED my surgery rotation, but I had a few times thrughout the year in which I had to step out. It was never an issue. It happens to lots of people. Some say it's getting used to rebreathing all that CO2 in your mask, some say it's not locking your knees. I can get faint just standing in a line too long--and it's totally random. I never lock my knees, I definitely never wore a t-shirt under my scrubs, and I always had food in my pockets. I'd make it through quintuple bypasses without a sweat, or I'd get faint during a basic lap-chole just shortly into it.

I tried to control for every factor I could going into each case, but sometimes it just happens, and once I'd start getting those pre-syncopal, diaphoretic symptoms, there was no turning back. I imagine I'm more of an exception with respect to those who pass out.

My biggest factor was OR temp. If it was too hot, it was all over but the cryin'. Those OB rooms were the worst.

I think you'll be fine if you keep a stash of food in your pockets and stay hydrated. Don't overdress. Know your symptoms well so you don't try to hold out too long. The most important point, as others have said, is to know when to call it quits.

Surgery is loads of fun! I hope you enjoy it.

good luck,
~kris

Definitely get a mask that breathes well. My friend and I both fainted b/c of that. She was unlucky and busted her forehead open on the floor. Needed stitches.

 

[bostonguy]

It is avoidable, i just finished 3rd year ending with surgery and ob/gyn. I knew early on that for me it was a function of how long ago I had eaten. And trust me, this is coming from someone who used to think I didn't have the guts for med school. My best times in surgery where actually when I was getting my hands dirty and covered in blood, hoorah! (PS I'm no future surgeon.)

During surgery I tried to eat 6 meals/day, up from my usual 2-3, and yes I gained about 5 pds, but only felt queezy once, when I was in back to back surgeries without eating, I was fine though, and just had a snickers aftewards.

It's not really about sleep, as you won't get much of that and it doesn't matter. Plus, that is more of an issue if you do overnight call on ob/gyn and end up in a crash C-section at 5 am having only 1 hour of sleep. Within 2 minutes I was awake, quick pee, sip of OJ (for the sugar), and already scrubbing in. That was the only time I remember having trouble being awake in surgery.

To everyone worried, you'll do fine, just eat, and if anyone gives you **** for it or laughs at you if you do pass out, then they are a massive insecure tool bag.

Have fun, you're actually getting to finally do something.

 

[denner]

I shadowed ED residents and was fine when observing patients w/ GSW or serious injuries. I've had blood drawn from me before and was fine. Don't have a needle / blood issue.

Then I went to my vet and saw him draw blood from my cat. I walked out of the room and dropped to the floor.

Go figure

I almost passed out one time in the OR, but it wasn't from the smell or the heat or the blood. It was from seeing skin get stretched in ways it shouldn't be, and I just kept picturing it happening to me, and all I remember saying is, "I'm gonna go sit in the corner" in a mumbling sort of way. Luckily somebody through a chair under me just in time and I was able to avoid passing out completely and feeling even more embarrassed.

And...
I know this particular post is a few years old, but this reminds me of my best fainting story EVAR

Anyways...
I was getting blood drawn for allergy testing or that pneumonia vaccine or something like that. I am in pretty good shape and have good veins so it wasn't an issue in the upcoming story. However, I was not looking at my arm while the nurse was taking blood because I am a little squeamish when the needles are going into me.

So anyways, its going fine, then all of the sudden, I believe the needle started to slip out, so the nurse tries to push it back in...bad f'n idea.
I have never felt such a sharp horrifying pain. I nearly kicked her in the ovaries. Anyways, she finishes up quickly and says, "Wait a second, don't look down, let me clean up first."

Which of course is code word to me for "You should probably look down and see how badly she mutilated your arm."

Pool of blood on the exam table that makes it look like I've been shot.
I lay down for 5-10 minutes, then walk about 20 feet down the hall to this little space in the wall with a couple chairs. The last thing I remember is feeling lightheaded, seeing those stars, and then reaching for the chair....

I wake up, lying on the ground in the middle of the hallway, sweating and freezing cold, with about 20 heads leaning out of doors like gophers all the way down the hall trying to see what all the noise was about, and a couple nurses/physicians hovering over me.

Apparently... I fell all the way back across the hallway, smoked my head on the metal doorframe (putting a big dent in it) of a physician's office (who was in it at the time), and knocking all his diploma/degree/framed things down onto the floor.

I have no idea how I didn't get a concussion, and they all thought I broke my neck and I had to get put on a backboard/x-rays, the whole shebang.
Oh ya...AND I WOULDN'T FIT HORIZONTALLY IN THE ELEVATOR ON THEIR BACKBOARD... Meaning I was pretty much standing up in the elevator with this thing attached to me.

I must have looked like the biggest melvin on the planet to the people trying to get on the elevator at each floor as the doors opened.

Ya...bad day...It still makes me cringe just thinking about her pushing that needle back into my vein.


I have no idea why I felt the need to embarrass myself with that story but I guess I needed some comic relief while studying hard for my DAT...

 

[sprinkibrio]

That is so damn funny. I can't believe you didn't have a concussion.

 

[asif2323]

hey..im a medical student…. fear and phobia are diffrent…. i dont have any problem in seeing the blood… or dissecting the cadavers…or watching autopsies..
i fainted thrice…. in my life…
once i was 7 ..and needle struck in my biceps as i flexed it out of fear//
then… i saw blood from my brothers nose.. it was just 4-5ml..during his sins surgery..
what actualy happens is..i think alot…. i imagine how actually its happening… and i feel my bp low… feel cold sweats… and heart becomes so weak… i never feel like vomiting…. but i feel contractions in my stomach….
then i fainted and got down on the floor .and becomes conciousless for 5-10minutes then after 20 minutes back to normal…. as its my profession..i dont know why it happens to me…..
thirdly..i saw syringing in optha.. there was no blood still i fainted… and i have to leave the site t get my self and concious back…

 

[doktorsethi]

Am ms2 student . In my case , something unusual happens .
Ideally i dont eat complete breakfast even during major surgeries, i dont faint.

But many of the times i have fainted during operating n assisting on circumcision operate. I think my mind is sensitive or have phobia about it.

Neverthless i have assisted in cholecystectomy/ carcinoma stomach , didnt fainted.

I agree with thread of other members, one shud make a point to eat before operate and remain hydrated . Any comments , suggestions please u r welcome

 

[tkhan180]

That is exactly what happened to me in the OR, I was watching a vaginal hysterectomy and it was fine for the first 30 min, and then I just blacked out and was transported to the ER (where I also volunteer!) It was a really embarassing experience, but I hope they'll let me back in for more surgeries now that I know better.

 

[LostCastleFan]

Hey everyone, I'm totally new here =)

I'm a brand new peds intern so I've gone through all rotations. So here's my story. . .


IM was my first rotation and my senior was putting in a central line under local anesthesia. It was my job to stand on the other side of the patient and hold up the sheet/sterile field that they put over the patient's face so he couldn't see what was going on. So my intern is the one actually attempting the line with my senior supervising and all of a sudden the patient starts saying something about being in pain and I felt all the blood drain out of my face and I must've turned white as a ghost because my senior asked if I was ok and told me to step out.
I had another instance during IM where my attending was doing a thoracocentesis while the pt wasn't completely under and then I saw how long the needle was and felt woozy.
During surgery my attending was removing a port under local anesthesia. I was holding the patient's hand when my surgeon started tugging at the port because it wouldn't come out easily since it was surrounded by fibrous tissue. My patient starting crying out and writing around from the pressure she was feeling while removing the port so I excused myself, gave her hand to the student next to me, and stepped out.
Now just this week my attending was doing circumcisions on a couple of our newborns and I got through the first one just fine, even though I don't like to see the little munchkins strapped down. But for some reason on the second one I felt lightheaded and nauseous and had to sit down. And I have seen a bunch of these during ob-gyn rotation with no problem whatsoever.

I've never actually fainted during a procedure/operation *knock on wood* but I'm really concerned with what's happening. I think that first IM experience just started it all. I always try to eat something, and drink something every couple of hours. It's almost like I psych myself out, like one of the other posters said happens with them. I think about feeling faint and voila, I do! Blood and guts don't bother me. It seems to be those procedures where my patient is awake or I feel that they're in pain. CVL are so close to important vessels that I get nervous for the patient! Now doing the procedure is different because since it's me doing it, I have no choice but to suck it up and move forward. I've actually just called the counseling center (which I get to go to for free since I work for the hospital) so hopefully one of the nice people over there can help me with some techniques to reduce my anxiety. I'd rather not be on a beta blocker for all of residency lol plus I'm just ashamed and embarassed that I've made it so far and I just can't seem to get over this one obstacle. If anyone has any suggestions asides from hydration, eating well, and not locking your knees, I'd appreciate it. I'll try and update on what the counselor says. Good luck to all of you!

 

[mrwesticles]

Also gotta push for compression stockings. They are cheap and a really really good idea for a lot of reasons, including venous health.

And you will feel dizzy before you faint, which is a blessing. Use that moment to sit down. It is MUCH more embarrassing (and dangerous) to faint than to take five.

 

[wannabeOBGYN]

i've heard that most med students will faint sometime during surgery. having fainted once before during 1st year (completely unexpected), this sort of freaks me out... does anyone know why it happens or what you can do to prevent it?

I've only passed out once during a surgery but have had pre-syncope a handful of times as well. I've passed out probably 6-8 times in the past so I usually know when it's coming and what to do. All the times I didn't faint were due to heat or not moving around or doing anything. The time I did faint was due to lack of food.

Story time!

I only had time to eat about half of my bagel with cream cheese because the attending showed up early. It was a total vaginal hysterectomy so I couldn't see much but was standing close by doing suction and occasionally holding a retractor if needed. Now, usually when I am about to faint it comes on slowly over 5-10 minutes so I have time to try to psych myself out of it or ask to leave/sit/break scrub. This time, however, it came on really fast. I started swaying on my legs and the last thing I remember is saying "I think I need to go to the bathroom" and hearing the scrub nurse say "That can't be good."

Based on the multiple retellings of what happened, at this point I started walking toward the sterile instruments with a glazed look on my face and they had to move everything out of the way as the doctor yelled "Catch her! She's fainting! Don't let her fall on the floor!" I came to a little while later on the floor with my gown, mask, and gloves off, staring at the ceiling and thinking, "This doesn't look like my room..." Luckily I didn't contaminate anything but I was completely mortified and had to sit in the PACU for half an hour eating crackers and juice. I was fine the rest of the day, especially since everybody knew what happened and forced me to eat everything they could get their hands on.

I probably apologized about 50 times but the doctor was very nice and sympathetic and told me she passed out so much in med school they nicknamed her for it. She joked that she was going to put my fainting in her LOR and say we bonded over it and that's how she knew I'd be a great doctor. Hopefully she didn't... :-\

In summary, always have food on you and in you, never wear a shirt under your scrubs, step back and ask to leave if you feel the warning signs. Most people, especially the nursing staff, are very helpful and nice about it. Everyone told me stories about when they or someone they knew fainted in the OR.

 

[wannabeOBGYN]

The typical OR is kept between 68 and 72 degrees.

Pediatrics and Burns rooms are usually much warmer (ie, 80 degrees and above). CT Surgery rooms are often the coldest.

Of course, being under the lights, being anxious and wearing gowns can increase the temperature, but how hot do you have to be to exacerbate your MS? I once worked with PA who wore this cooling machine from Sharper Image around his neck...looked dorky, but it kept him cool. Don't wear a t shirt under your scrubs, wear the bouffant hat, etc. to keep yourself cooler.

All of our ORs were 62-66 except one that was kept around 70-72. I much prefer the cold rooms.

 

[yellowfinGuy]

This is going off the path just a bit but it stays on fainting, someone had mentioned cadavers. How was it when you took the gross anatomy of med school? seeing the face and what not for the first time along with the stench of preservation?

 

[bioteach]

This is going off the path just a bit but it stays on fainting, someone had mentioned cadavers. How was it when you took the gross anatomy of med school? seeing the face and what not for the first time along with the stench of preservation?

I am prone to fainting and thought I'd have a big problem in anatomy, but nothing at all. The first few days I took extra precautions (sitting often, eating plenty ahead of time).

The only time I was pre-syncopal enough to need to sit down was during an elective at the coroner's office. Watching them cut the skull off and take out the brain was amazing but got me dizzy. Also, hemodialysis makes me pre-syncopal. Can't handle watching all the blood in the tubes, but trauma surgery...no problem. Can't make much rhyme or reason out of it.

I was always sure to wear compression hose, drink LOTS of water and have a very salty food beforehand (I have a low resting BP, so this helps me keep my baseline up).

The only time I fainted during medical school was during NICU rounding, but I was 20 weeks pregnant so that doesn't count.

 

[ArcGurren]

This is going off the path just a bit but it stays on fainting, someone had mentioned cadavers. How was it when you took the gross anatomy of med school? seeing the face and what not for the first time along with the stench of preservation?

The only smell that I really encountered was that of formaldehyde, which doesn't bother me all that much.

It bothered me the first time I saw it, and then I got over it for the most part. These bodies are donated by people who have used their final act (literally) to contribute to your education - respect them and use them to help you learn, and your view towards them will change.

 

[PsychPhDone]

Hey everyone, I'm totally new here =)

I'm a brand new peds intern so I've gone through all rotations. So here's my story. . .


IM was my first rotation and my senior was putting in a central line under local anesthesia. It was my job to stand on the other side of the patient and hold up the sheet/sterile field that they put over the patient's face so he couldn't see what was going on. So my intern is the one actually attempting the line with my senior supervising and all of a sudden the patient starts saying something about being in pain and I felt all the blood drain out of my face and I must've turned white as a ghost because my senior asked if I was ok and told me to step out.
I had another instance during IM where my attending was doing a thoracocentesis while the pt wasn't completely under and then I saw how long the needle was and felt woozy.
During surgery my attending was removing a port under local anesthesia. I was holding the patient's hand when my surgeon started tugging at the port because it wouldn't come out easily since it was surrounded by fibrous tissue. My patient starting crying out and writing around from the pressure she was feeling while removing the port so I excused myself, gave her hand to the student next to me, and stepped out.
Now just this week my attending was doing circumcisions on a couple of our newborns and I got through the first one just fine, even though I don't like to see the little munchkins strapped down. But for some reason on the second one I felt lightheaded and nauseous and had to sit down. And I have seen a bunch of these during ob-gyn rotation with no problem whatsoever.

I've never actually fainted during a procedure/operation *knock on wood* but I'm really concerned with what's happening. I think that first IM experience just started it all. I always try to eat something, and drink something every couple of hours. It's almost like I psych myself out, like one of the other posters said happens with them. I think about feeling faint and voila, I do! Blood and guts don't bother me. It seems to be those procedures where my patient is awake or I feel that they're in pain. CVL are so close to important vessels that I get nervous for the patient! Now doing the procedure is different because since it's me doing it, I have no choice but to suck it up and move forward. I've actually just called the counseling center (which I get to go to for free since I work for the hospital) so hopefully one of the nice people over there can help me with some techniques to reduce my anxiety. I'd rather not be on a beta blocker for all of residency lol plus I'm just ashamed and embarassed that I've made it so far and I just can't seem to get over this one obstacle. If anyone has any suggestions asides from hydration, eating well, and not locking your knees, I'd appreciate it. I'll try and update on what the counselor says. Good luck to all of you!

Just popping in to suggest requesting a therapist there who is familiar with applied tension. It's a technique that should help you raise your blood pressure. A good therapist will also likely help you emulate the feelings of passing out and practice applying the techniques they show you. If you request a cognitive behavioral therapist, they should likely know the protocol.

Okay I'll sneak back to "my" forum now.

 

[Angel1982]

I sometimes have a problem with pain related presyncopal events. Interestingly enough, I am much more affected when it is someone else causing the pain (although one time I barely managed to finish putting a foley in before I had to run and put my head between my knees-and it wasn't even my first time doing it). It doesn't happen with everything (I want to do ortho and haven't had a problem watching/doing reductions, or seeing people with bad injuries scream and cry). I associate it with identifying too much with the patient and relating it to my personal experiences with pain (several surgeries and unfortunately very tolerant to narcotics=bad post op recovery). When I am more of an active participant I can't do this and therfore stay upright. If you have a problem once or twice, try not to dwell on it as the anxiety over it happening again will not help prevent it. If it is a recurrent problem, try to analyze what factors might be involved (overheating, hunger, emotional reaction, etc) and do what you can to control them. If all else fails you can try shuffling your feet, bending your knees, biting your tongue to try to hang on but at a certain point you need to concede defeat and avoid falling down by sitting, squatting, or laying down.

I totally agree with you. Sometimes I am absolutely fine watching gun shot wounds, C-sections and other trauma. Blood doesn't bother me, I am a phlebotomist (or was, but every once in a while I see something that makes me drop. Usually episiotomies make me dizzy so I look away, and when had my own baby, rejected it, preferred to tear. go figure.
A few months back in the ED I was watching a resident ligating an artery on a sliced finger, and when she was pulling the suture out she didn't realize that the hook was there and was tearing through the tissue causing even more bleeding. I was bent over the gurney at that point so I was fine, but her phone rang, she asked me to get it, so I got up and sure enough started feeling that the inevitable was going to happen. Once it starts, everything is useless, it is going to happen. So I stepped out and asked a nurse to sit down...and she didn't let me...so she had to catch me ha It was embarrassing though.
Last year I fainted during an emergency delivery simulation (on a rubber perineum). The instructor was using terrible terms like "vagina explosion" and since I had recently had a baby and to this day remember the feeling of tearing I went down
I am actually dreading the surgery but really want to get over this fear. Ever since that incident in the ED I am very anxious! I am considering urology as specialty so I really want to get over this bull...

 

[Lolscan]

i've heard that most med students will faint sometime during surgery. having fainted once before during 1st year (completely unexpected), this sort of freaks me out... does anyone know why it happens or what you can do to prevent it?

It happens and you can't control it for the most part. Anxiety and stress is part of the cause. Just keep yourself hydrated and eat when you can. If you feel dizzy or weird vagal sensation in your gut then tell your attending and sit down right away. Or even just sit on the floor before you fall. No one will fault you for it.